tbuckley/cabot-search huggingface dataset:
Evaluation of the geriatric 8 (G8) screening tool in a multi-ethnic Asian population of older adults with cancer: Results from Geriatric Oncology Longitudinal End to eNd (GOLDEN) Study.
Authors: Matthew Zhixuan Chen, Nydia Camelia Rais, Jeremy Chee Seong Tey, Natalie Mun Wai Ling, Yean Shin Ng, Meiling Chun, Noorhanah Mohd Said, Wan Nghee Eng, Francis Ho, Shien Ling Angela Pang
Journal: Journal of Clinical Oncology (2022)

e24029 Background: The Geriatric 8 (G8) questionnaire has been validated predominantly in Western populations as a screening tool to identify vulnerable older adults with cancer who would benefit from comprehensive geriatric assessment (CGA). Given the paucity of evidence of the performance of this tool in a multi-ethnic Asian population, there is a need to determine whether the established cut-off score of 14 should be adjusted for improved performance in this population of older adults. Methods: Prospective cross-sectional study was done in older adults aged ≥ 65 years in the outpatient setting of an academic tertiary cancer center, the National University Cancer Institute, Singapore (NCIS). G8 questionnaire and CGA were conducted for eligible patients. The performance of the G8 screening tool in identifying patients who would benefit from a CGA was evaluated using receiver operating characteristic (ROC) curve analysis: area under the curve (AUC), sensitivity (Sn), and specificity (Sp). Results: 180 participants (mean age 74 years) were included in the study. 40.5% were female. 90% were Chinese, 7% were Malay, 2% were Indian. 57.8% were pre-frail and 12.8% were frail. The top five cancers in our study population were colorectal (30%), lung (25%), head and neck (12%), upper gastrointestinal (10%) and gynecological (7.0%). ROC analysis showed an AUC of 0.73 (95% CI 0.65 – 0.80) with an optimal cut-off score of 13 (Sn 71.7%, Sp 74.0%). Conclusions: G8 performed well in identifying older adults with cancer who would benefit from a CGA, in a multi-ethnic Asian population. In our cohort, we found that a slightly lower cut-off score of 13 performed better, and should be taken into consideration as part of daily oncology practice in Asia. Future research efforts should go into examining the biological aspects of frailty in this population.
LINC-18. Challenges in the neurosurgical care of pediatric patients with central nervous system tumors during the COVID-19 pandemic
Authors: Jared Paul Golidtum, John Emmanuel Custodio, Jochrys Estanislao, Jose Carlos Alcazaren, Kenny Seng, Joseph Erroll Navarro, Ronnie Baticulon
Journal: Neuro-Oncology (2022)

Abstract INTRODUCTION: Central nervous system (CNS) tumors account for 20 - 30% of all childhood cancers. The Philippines is a lower-middle income country, wherein brain centers are located mostly in urban areas. We aimed to identify challenges that pediatric patients with CNS tumors encountered during the COVID-19 pandemic, which aggravated delays in their diagnosis and treatment. METHODS: This is a retrospective review of all pediatric patients who underwent neurosurgery for CNS tumors at the Jose R. Reyes Memorial Medical Center, a tertiary referral center, from January 2020 until December 2021. We summarized patients’ demographic data, clinical course, and perioperative outcomes. RESULTS: A total of 38 pediatric patients underwent neuro-oncologic surgery in our center during the study period. There were 18 males and 20 females, with a mean age of 7.5 ± 4.9 years. Tumor was biopsied and/or resected in 35 cases (92%). The most common histologic diagnoses were medulloblastoma (n=8, 21%) and high-grade glioma/glioblastoma (n=5, 13%). Median preoperative length of stay and total length of stay were 10 (IQR: 17) and 28 (IQR 33.75), respectively. There was a high perioperative mortality rate in 2020 (71%), but this decreased to 20% in 2021. Six patients (16%) developed COVID-19 infection during the perioperative period. There were nine patients (24%) who had documented tumor progression because of delays in adjuvant therapy. DISCUSSION: Aside from geographic barriers and catastrophic health expenditure, the major challenges that disrupted the care of pediatric patients with CNS tumors in our center during the COVID-19 pandemic were delays in neuroimaging for diagnosis, unavailability of operating room slots, deficiency in critical care beds, and workforce shortage due to COVID-19 infection among health workers. Health care systems must adapt to the changes brought about by the pandemic, so that children with CNS tumors are not neglected.
Financial distress, health literacy, numeracy, and treatment receipt by race/ethnicity amongst breast cancer survivors.
Authors: Ashley Odai-Afotey, Ruth Lederman, Naomi Y Ko, Haley Gagnon, Dawn L. Hershman, Katherine D. Crew, Nancy Lynn Keating, Daniel A. Gundersen, Anna C. Revette, Rachel A. Freedman
Journal: Journal of Clinical Oncology (2022)

e18554 Background: Low-income and minority women are less likely to receive breast cancer treatments and have higher mortality rates compared with other women. We examined economic hardship, health literacy, and numeracy by race/ethnicity and whether these factors were associated with differences in receipt of recommended treatment. Methods: We conducted a telephone survey in 2018-2020 of adult women diagnosed with stage I-III breast cancer between 2013-2016 at three centers in Boston and New York. We asked women about treatment receipt and factors contributing to decision-making. We used X 2 and Fischer exact tests to examine associations between economic distress, health literacy/numeracy, and treatment receipt by race/ethnicity. Results: Among 326 respondents (AAPOR cooperation rate 63-80% across sites), 55% were Non-Hispanic (NH) White, 23% were NH Black, and 14% Hispanic; 15% were Medicaid-insured. Due to item non-response, sample sizes ranged from 294-315 per question. A substantial proportion of women, and particularly Black and Hispanic women, reported economic distress, worse finances over time, and low literacy/numeracy (Table). Overall, 7% (n = 22) did not initiate at least one recommended treatment. Although we observed no differences in treatment by race/ethnicity (p = 0.70), those not initiating recommended treatment(s) reported more worry about paying large medical bills (52% vs. 27%) and covering visit costs (27 vs. 10%); p &lt; .05 for both. Conclusions: In a diverse sample of breast cancer survivors, financial distress was common, particularly for non-White participants; non-White women also had lower literacy/numeracy. Although we observed some associations of these factors (but not race/ethnicity) with less receipt of recommended treatments, because few women declined treatments, understanding the scope of impact is limited. However, our results highlight the importance of up-front and longer-term assessments of resource needs and allocation of support for breast cancer survivors. Novelty of this work includes the granular measures on financial distress and the focus on health literacy/numeracy among a diverse population.[Table: see text]
HGG-37. A case of<i>ETV6-NTRK3</i> fusion driven infantile hemispheric glioma (IHG) with acquired drug resistance against first- and second-generation NTRK-inhibitors
Authors: Dennis T L Ku, Anthony P Y Liu, Amanda N C Kan, Liz Y P Yuen, M K Shing, Carol Y L Yan, Eric Fu, Jeffrey P W Yau, C W Luk, H K Ng, Godfrey C F Chan
Journal: Neuro-Oncology (2022)

Abstract A 3-month-old girl had left cerebral infantile hemispheric glioma (IHG), H3 wild type (wt), Grade IV (WHO2020) with diffuse leptomeningeal and spinal metastasis. Craniotomies were performed twice which achieved partial resection. Histopathology revealed high grade glioma, Ki67 30-40%, mitosis and widespread necrosis. IHC showed H3wt, IDH-, and retained INI-1. RNAseq found ETV6-NTRK3 fusion. She was treated per Baby POG-9233, however after 3 cycles, there was mixed response (static for primary, partial response for metastasis). She had severe developmental delay, right hemiparesis and dysphagia. Aiming for better disease control and potential resectability, we switched to first-generation NTRK-inhibitor, Larotrectinib. MRI at 3 months showed significant interval reduction in tumour size, then became static at 6 months. She was stable with gradual neurological improvement until 10 months after Larotrectinib, there was worsening neurology and imaging confirmed tumour progression with haemorrhage. Craniotomy was performed for haemostasis and tumour debulking. Histopathology showed same IHG with ETV6-NTRK3 fusion. Targeted panel sequencing found NTRK3 p.Gly623Arg mutation, a solvent-front substitution responsible for acquired resistance to first-generation TRK-inhibitors. BRAFV600E and MET amplification were not detected. Larotrectinib was switched to second-generation NTRK-inhibitor, Selitrectinib. MRI at 1 month showed post-operative changes, but disease progressed at 3 months and in an accelerated manner over the course of 10 days while on therapy. Choice of conventional chemotherapy and radiotherapy were discussed, but the girl deteriorated rapidly and deceased (3 months from start of Selitrectinib, 19 months from diagnosis). CONCLUSION: IHG is aggressive with challenging surgery and medical treatment. The use of small molecular inhibitor requires careful consideration, i.e. treatment effect, toxicity and potential acquired drug resistance as showed in this case. For unresectable tumour, it may be inevitable as we also reported a similar case with ROS1 fusion. Access to newer novel agents is difficult while therapeutic effect is uncertain.
Laparoscopic colposacropexy technical considerations
Authors: M.C. Conde Redondo, F. Castroviejo Royo, J. Diez Rodriguez, A. Alonso Villalba, M. Bedate Núñez, E. Valsero Herguedas, A. Ruano Mayo, Á. Zamora Horcajada, F. Natal Alvarez, L. Cuellar Martín
Journal: European Urology (2022)
QOL-16. A 6-year longitudinal study of neurocognition in children treated for a brain tumor
Authors: Kristien Bullens, Charlotte Sleurs, Linde Van den Wyngaert, Karen Vandenabeele, Trui Vercruysse, Laura Claeys, Sofie Prikken, Sandra Jacobs, Jurgen Lemiere
Journal: Neuro-Oncology (2022)

Abstract Long-term neurocognitive difficulties in children treated for a brain tumor are well documented and known to be affected by treatment. However, longitudinal studies of these neurocognitive difficulties are scarce. In the present study, we investigated the impact of radiotherapy (RT) on the evolution of neurocognition between different consecutive time points after diagnosis, and throughout treatment and survivorship. This study included 69 children diagnosed with a brain tumor at the University Hospitals Leuven who completed a comprehensive neuropsychological test battery (intelligence, memory, visuomotor functioning, and QoL) on at least three consecutive time points (2-year interval). Of all patients, 40 completed the test battery at 4 time points. The first assessment was conducted at the earliest possible moment after diagnosis and before the start of any adjuvant therapy. Mean age at diagnosis and first assessment were 7.75 and 7.92 years, respectively. The most common diagnoses were pilocytic astrocytoma (n=33) and medulloblastoma (n=11). 29.0% of the children received local RT and 15.9% received craniospinal RT. A repeated measures analysis with cranial irradiation (no, focal, craniospinal) as between-subjects factor and age at diagnosis as covariate demonstrated a significant interaction effect between time and type of irradiation for both overall intelligence (p=0.007) and QoL (p=0.006) for children with three and four assessments. Children who received craniospinal irradiation demonstrated a significant decline in overall intelligence and a significant worsening of QoL. For the non-irradiated group, an improvement of QoL was observed. For processing speed, a significant time effect was found for children with three and four assessments (p&amp;lt;0.001), with a significant improvement for the overall group. The results of this longitudinal study demonstrated diverse longitudinal trajectories. Children who received craniospinal irradiation are most often confronted with intellectual decline and worsening of QoL.
RARE-17. Multi-institutional craniopharyngioma cohort highlights need for more comprehensive data collection on comorbidities and quality of life
Authors: Emily Marshall, Julia Crowley, Shana McCormack, Brian Rood, Todd Hankinson, Sylvia Cheng, Michael DeCuypere, Sandi Lam, Stewart Goldman, Lance Ballester, Walter Faig, Ryan Velasco, Kamnaa Arya, Phillip Jay B Storm, Adam Resnick, Michael Prados, Sabine Mueller, Fatema Malbari, Cassie Kline
Journal: Neuro-Oncology (2022)

Abstract BACKGROUND: Pediatric craniopharyngioma is associated with long-term survival, but tumor- and therapy-related complications often negatively impact quality of life (QoL). Standard treatments include resection and radiation, but institutional practices vary and recurrence rates remain high. In this review, we utilized a cohort from the Children’s Brain Tumor Network (CBTN) to evaluate outcomes for craniopharyngioma. METHODS: CBTN provides clinical and genomic data for pediatric patients diagnosed with primary central nervous system tumors across 25+ institutions. We collected data for 124 patients, ages 0-21, diagnosed with craniopharyngioma between 2012-2020. Variables collected included treatment, recurrence/progression, and comorbidities. RESULTS: Excluding patients without confirmed pathologic diagnosis (n=10) or follow-up data (n=39), 75 patients remained. For initial treatment, most (n=46, 61%) received surgery alone (9 partial, 33 near-total resection). Twenty-six (35%) underwent both surgery and radiation, with 9 receiving both therapies upfront and 17 receiving radiation at progression/recurrence. Four (5%) patients received chemotherapy. Over half of the cohort (n=39, 52%) had at least one progression/recurrence, and four died (5%). Significantly higher rates of progression/recurrence (84% vs. 32%, p=4.0e-5) were identified in patients that had surgery and radiation, compared to surgery alone. Time to recurrence, progression, or death was shorter for the surgery and radiation group (HR=4.1, p&amp;lt;1.0e-4), and for those that underwent partial versus near-total resection (HR=2.7, p=0.1.2e-2). Comorbidities were likely underreported, based on low rates of visual (32%), neuroendocrine (27%), and neurologic (28%) deficits at diagnosis, and 29 patients (39%) with unspecified medical history. CONCLUSIONS: CBTN provides a robust repository of information on treatment and survival of craniopharyngioma patients. However, we found a paucity of data on associated comorbidities and QoL outcomes. We advocate that future datasets and clinical trials routinely collect functional outcomes alongside therapy and survival data, particularly in craniopharyngioma where long-term survival is balanced with future QoL.
Feasibility of laser lithotripsy using robotic retrograde intrarenal surgery system easyUretero and Auriga XL™ Holmium laser in porcine model
Authors: H.H. Han, Y.J. Moon, H.D. Jung, J. Kim, B. Cheon, J. Han, S.Y. Cho, D-S. Kwon, J.Y. Lee
Journal: European Urology (2022)
PRO-based symptom management versus usual care for patients with gastric and esophageal cancer who undergone previous surgery: A randomized controlled trial.
Authors: Yifu He, Shusheng Wu, Conglan Ding, Liyuan Fan, Lihong Ke, Ying Yan, Mengge Li, Huiqin Luo, Xiaoxiu Hu, Jiayu Niu, Huimin Li, Huijun Xu, Wenju Chen, Lulu Cao
Journal: Journal of Clinical Oncology (2022)

e16104 Background: In China, the incidence of gastric cancer and esophageal cancer ranks second and third, respectively. These patients often suffer from malnutrition, anorexia and gastroesophageal reflux, which have a serious implication on their subsequent treatment. However, due to the specificity of the current medical situation in China and the heavy treatment workload of clinicians, there is no efficient and easy way to manage the symptoms of these patients. Methods: Subjects were randomized in a 1:1 ratio after enrollment into the Patient-Reported Outcome (PRO) -based symptom management group and the usual care group. The PRO group were assessed for anorexia, gastroesophageal reflux, nutritional status, BMI in the hospital before each cycle of chemotherapy via an electronic data platform. The doctors responded the assessment results and provided interventions, including advice for home care, drug prescription, and telephone follow-up, before patients are discharged from the hospital. Patients were assessed and managed every 3-4 weeks at the time of return for chemotherapy during 16 weeks. Patients in the usual care group underwent symptom assessment only the first and the 16th weeks, during which the surgeons only managed the symptoms with usual care modalities. The primary endpoint is number of symptoms at the 16th weeks and the secondary endpoint are the incidence of each symptom at the 16th weeks. Results: The interim results of the trial is reported. From Apr 2021 to Dec 2021, 55 pts completed the clinical observation, including 25 pts in the PRO group and 30 pts in the usual care group. The number of overall symptoms in the PRO group was significantly lower than in the usual care group (1 (0-1.5) vs 2 (1-3)). The incidence of nutrition risk (28.0% vs 56.7%), anorexia (24.0% vs 60.0%) and gastroesophageal reflux(8.0% vs 50.0%) in the PRO group was significantly lower than that in the usual care group, and there was no statistically significant difference about underweight (defined: BMI&lt;18.5, 24.0% vs 36.7%) and depression (0.0% vs 6.7%). Conclusions: Compared to usual care, nutritional risk, anorexia, and GERD rates were effectively controlled in patients with previously surgically resected gastric and esophageal cancers through 16 weeks of patient-reported outcome based symptom management, with assessment scores confirming the same results, providing clinicians with an easy-to-operate and effective means of symptom management. Clinical trial information: ChiCTR2100041701. [Table: see text]
RONC-16. Proton therapy for patients with embryonal tumor with multilayered rosettes in early childhood – results of the prospective KiProReg Study
Authors: Sarah Peters, Sabine Frisch, Julien Merta, Christian Bäumer, Christoph Blase, Stephan Tippelt, Barbara von Zezschwitz, Pascal Johann, Katja von Hoff, Dirk Geismar, Beate Timmermann
Journal: Neuro-Oncology (2022)

Abstract OBJECTIVES: Embryonal tumors with multilayered rosettes (ETMR) are rare malignancies of the central nervous system occurring predominantly in early childhood. Little is known about optimal time point and target volume of radiotherapy for the respective patients. The aim of this analysis was to evaluate treatment outcome in pediatric patients with ETMR treated with Proton Therapy (PT). METHODS: Between May 2016 and August 2021, 15 patients (9 male /6 female) with ETMR received PT in our institution and were enrolled in the prospective registry study KiProReg. Patient characteristics, treatment and outcome according to standardized follow-up data were descriptively analyzed by summarizing frequencies due to small sample size. RESULTS: Median age at PT was 3.0 years (range, 1.6-4.0 years). Three patients presented with metastatic disease (M1 n=1; M2 n=1; M2/3 n=1). Eight patients were treated with salvage PT at tumor progression or recurrence. Residual disease was present in three patients at start of PT. Tumor site was infratentorial (n=3) or supratentorial (n=12). All patients received Chemotherapy (CTX) prior to PT including high dose CTX (n=9) and intrathecal CTX (n=3). Concomitant CTX with temozolomide was administered in one patient. Patients received local PT (n=8) or craniospinal irradiation (CSI) followed by a local boost (n=7). Median dose was 54.0 Gy(RBE) (range, 3.6 -59.4 Gy(RBE)). PT was terminated prematurely in one patient due to cerebral edema and disease progression. Median follow-up after diagnosis was 16.3 months (range, 6.6-65.7 months) and 5.1 months (range, 0-62.4 months) after PT. Four patients treated for salvage experienced disease progression within three months after PT, three of them deceased. CONCLUSION: Preliminary results suggest promising outcomes for childhood ETMR after PT, especially in patients treated at initial diagnosis. Longer follow-up and larger cohorts are desirable to assess long-term survival and necessity of CSI.
Socioeconomic disparities in supportive therapy use and tolerance of aromatase inhibitors in patients with early-stage, hormone-positive breast cancer.
Authors: Melanie Wain Kier, Zhiqiang Li, Nicole Casasanta, Rima Patel, Parul Agarwal, Brittney Shulman Zimmerman, Yunchen Yang, Marc Y Fink, Xiang Zhou, Scott Newman, Rong Chen, Eric Schadt, William K. Oh, Amy Tiersten
Journal: Journal of Clinical Oncology (2022)

523 Background: Socioeconomic disparities impact breast cancer survival with significantly higher mortality among women of lower socioeconomic status. Little is known about how disparities affect patients with early-stage hormone receptor positive (HR+) breast cancer (BC) and patients’ tolerance and adherence to standard of care adjuvant aromatase inhibitor (AI) therapy. AI-related adverse effects are common and can cause therapy intolerance and early discontinuation. Supportive therapies have been shown to improve symptom tolerability when utilized by patients. This study assessed socioeconomic disparities in utilization of supportive therapies and adherence to initial AI therapy. Methods: We performed a retrospective chart review of all female patients at our academic institution with early-stage, HR+, BC who were initiated on adjuvant AI between 2011-2020. We collected information on side effects, duration of first AI and use of supportive therapies. We linked median family income with zip codes based on national census data and sorted them based on the Pew Research Center categorization. Primary endpoints were the rate of discontinuation of AI at 1-year and utilization of supportive therapies in relation to income, insurance coverage and primary language. The Fisher's exact test, Pearson's Chi-squared test, and Wald test methods were used to compare rates of discontinuation of front-line AI therapy and use of supportive therapies for each group. Results: We identified 1006 patients of whom 95% (n = 954) had AI related side effects yet only 31% (n = 311) received supportive therapies in the first year of AI treatment. The majority (59%) of patients were in the middle-income range ($52,200-$156,000), followed by upper (24%) and lower (17%) income. Upper-income was associated with higher use of supportive therapies (OR 1.46, p = 0.031) but was not associated with lower 1-year discontinuation rate. Medicare was the most common insurance coverage (45%), followed by Commercial (32%) and Medicaid (23%). English was the primary language for 86% of patients. Neither insurance coverage nor primary language was associated with either endpoint. In evaluating race, Black patients had the least use of supportive therapies (p &lt; 0.001), yet this group had the lowest 1-year discontinuation rate (p = 0.005). Conclusions: Our results demonstrate that income and race were associated with use of crucial supportive therapies that are proven to help patients mitigate AI toxicities. The etiology of these disparities is likely multifactorial and requires further study to ensure equitable care and access for all patients.
Robotic radical cystectomy with intracorporeal ileal conduit: Surgical technique, perioperative, functional and oncologic outcomes
Authors: L. Misuraca, G. Tuderti, U. Anceschi, R. Mastroianni, A. Brassetti, M. Ferriero, A.M. Bove, S. Guaglianone, M. Gallucci, G. Simone
Journal: European Urology (2022)